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FAAL DAN DISFUNGSI PANKREAS1

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3INSULIN ANABOLIK me penimbunan glukosa, asam lemak dan asam amino

GLUKAGON CATABOLIC me mobilisasi glukosa, asam lemak dan asam amino dari depo ke dalam aliran darah (sirkulasi)

Ekses insulin - hipoglisemia - konvulsi - koma

Defisiensi Insulin diabetes mellitus bila tidak diobati fatalEkses glukagon diabetes tambah parahDefisiensi glukagon hipoglisemiaEkses somatostatin hiperglisemia

4BIOSINTESA DAN SEKRESI INSULIN

Insulin : polypeptida 2 rantai lurus AARantai A 21 AA B 30 AA T1/2 insulin : 5 menit 111677192013021SSSSSSRantai ARantai B5

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7C - Peptide 31 AA 10% aktivitas insulin

Kallikrein jaringanProinsulin insulin

7% aktivitas insulin plasma dikurangi oleh antiinsulin antibody93%: nonsuppressible insuline like activity (NSILA)5% NSILA peptide growth factors dengan insuline like activity, yaitu:- IGF-I- IGF-II- Somatomedin A- Somatomedin C- Multiplication Stimulating Activity (MSA)88% NSILA nonsuppressible insuline like protein (NSILP)8

9Otot glucosa glycogenesisinsulinglycogenglycogenHatiglucosaHatiProteinLemakglucosaglycogenolysisGHGlucagonAdrenalingluconeogenesisglukokorticoid10DIABETES MELLITUS- Insulin defisiensi - Glucosuria- Polyuria - Ketosis- BB meskipun polyphagia - Acidosis- Hyperglycemia - Coma

GLUCOSE TOLERANCE TEST

BENEDICT TEST Positif Bila Kuning Jingga11 Waktu (jam) sebelum sc. Insulin

Macam insulin Aktivitas puncak Lamanya kerja

Crystalline zincInsulin (C2I) 2-3 5-7

NPH insulin (neutral, protamin-hagedorn insuline) 10-20 24 28

Lente insulin 10-20 24 28

Protamine zinc insulin 16-24 36+ (PZ1)12

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14Glucose transporters familyFunctionKm(Mm)Major Sites of expressionActive transportSGLT1(Na+-glucose cotransporter)Secondary active transport of glucose0,1-10Small intestine, renal tubulesFacilitatedGLUT 1Basal glucose uptake1-2Placenta, brain, red cells, kidneys, colon, many other organsGLUT 2B cell glucose sensor; transport out of intestinal and renal epithelial cells12-20B cells of islets, liver, ephitelial cells of small intestine, kidneysGLUT 3Basal glucose uptake